设计性实验在人体寄生虫学实验教学中的应用效果

在本院2005和2006级医学本科生中开展人体寄生虫学设计性实验研究，对学生们设计的实验方案进行分析讨论，并对可行性的实验方案进行实践。学生们对设计性实验有很高的兴趣并积极参与，实践证明设计性实验能够使理论联系实际，培养学生的科研和实践能力，提高了教学质量。     

设计性实验在卫生微生物学实验教学中的实践与体会

为了推进微生物实验教学改革,以本校预防医学专业学生为研究对象,进行设计性实验教学探索,并结合教学实践对教学效果和开展设计性实验需要重视的问题进行分析总结。结果表明,设计性实验有利于激发学生的学习兴趣和主动性,有利于培养学生的实践能力、团队精神和科研意识,有利于营造教学相长的氛围,是传统教学模式的有益补充和尝试。     

病原生物学设计性实验教学在留学生中的应用

目的增强留学生对基础理论、基本知识和基本技能的学习,同时,提高其分析问题、解决问题的能力及创新思维的医学综合能力。方法将留学生按国籍分组并结合本国病原性疾病流行状况,在教师指导下自主参与"讲座-选题-设计-实施-总结"的设计性实验教学法教学过程。结果设计性实验教学法对留学生学习有很好的促进作用。结论在留学生中开展设计性实验课程的综合教学模式是传统教学模式的有益补充和尝试,为构建新型的留学生病原生物学课程体系奠定基础。     

侵袭性真菌感染的流行病学及其高危因素

真菌在正常人的皮肤、口腔、肠道、阴道等均可分离到,多为念珠菌,属正常菌群或条件致病菌.真菌病可根据真菌侵犯部位的不同而分为浅部真菌病和侵袭性真菌病.浅部真菌病系指表皮、毛发和甲板的真菌感染,又称癣.     

原发性下肢静脉瓣膜关闭不全的临床特征

1983～1986年,本院收治下肢静脉郁滞患者共88例,分析如下。一、X线造影: 作上行性静脉造影时,先用止血带扎住踝部浅静脉,取头高足低30°斜立位,然后穿刺足背浅静脉,5分钟内注入40%泛影葡胺     

综合设计性实验在人体寄生虫学实验教学中的应用

为了更好地完成人体寄生虫学教学,提高学生的学习兴趣和解决实际问题的能力,作者在人体寄生虫学实验教学中采用综合设计性实验方法 ,改变传统的固化的验证性模式,灵活应用动物模型,将常用的寄生虫临床检验和操作方法设计整合到该动物模型中,通过学生自己设计并亲自操作,提高了学生综合素质。     

设计性实验及开放实验室教学法在微生物学检验实验教学中的应用

在检验专业四年制本科学生微生物学检验实验课程中开展了设计性实验及开放实验室教学法的尝试。结果显示该教学法明显优于传统教学法,有利于实验教学资源的充分利用,能增加学生的学习机会,培养和提高学生的综合能力,并能激发教师的教学责任感。     

不同真菌感染对肝衰竭患者病情及预后的影响

目的研究不同真菌感染对肝衰竭患者病情及预后的影响。方法总结肝衰竭合并不同真菌感染患者的临床资料,分析后者对患者病情和转归的影响。结果在资料完整的200例患者中,亚急性肝衰竭3例,慢加急性肝衰竭92例,慢性肝衰竭105例。其中浅部真菌感染39例,侵袭性念珠菌感染89例,侵袭性曲霉菌感染72例。感染前三组患者的终末期肝病模型（MELD）评分分别为25.3±6.0、25.1±6.4和26.2±6.2（P〉0.05）,感染后则分别为25.8±8.7、28.7±9.8和32.9±7.7（P〈0.05）。MELD评分分别增加0.46、3.66和6.75,感染后三组间MELD评分比较,有显著性统计学差异（P=0.000）。浅部真菌感染出院时生存18例（46.1%）,死亡21例（53.9%）,侵袭性念珠菌感染生存34例（38.2%）,死亡55例（61.8%）,侵袭性曲霉菌感染生存11例（15.3%）,死亡61例（84.7%）,三组间病死率比较,差异显著（P〈0.05）。结论侵袭性曲霉菌感染对肝衰竭患者病情恶化的影响最明显,其次是侵袭性念珠菌感染,浅部真菌感染影响较小。     

构建医学检验本科微生物学及微生物学检验实验教学体系的探讨

根据医学检验专业的办学定位及培养目标,提出了改革微生物学及微生物学检验实验教学体系的新思路,以培养面向21世纪微生物学检验的高级应用型技术人才为目标,创建了多层次教学模式,即基础教学为主,研究型教学为辅,增加综合性设计性实验,形成开放式实验教学体系。这种实验教学体系的形成,既能强化学生的基本既能训练,又能提高学生的分析问题、解决问题及创新能力。     

评估动物实验偏倚风险的SYRCLE工具实例解读

目的通过对动物实验偏倚风险评估工具SYRCLE的解读,促进其正确理解和使用。方法逐条解释SYRCLE工具的评估条目,并用该工具示范性评估干预性研究《双孢菇胞内和胞外多糖对伴刀豆凝集素A诱导免疫性肝损伤小鼠的保护作用》的偏倚风险。结果示例干预性动物实验的整体偏倚风险程度为"高",主要包括选择性偏倚、测量偏倚等。结论 SYRCLE是目前值得推荐的动物实验偏倚风险评估工具。研究者在进行动物实验的设计、实施和结果分析及评价时,均可参照该工具条目以减小偏倚风险,提高动物实验的方法质量。     

Intracutaneous versus transcutaneous suture techniques: comparison of sternal wound infection rates in open-heart surgery patients

In open-heart surgery, sternal wound infection after median sternotomy is a critical complication. The intracutaneous suture is conventionally used in closing sternal incisions. In this prospective, randomized, controlled clinical trial, intracutaneous and transcutaneous suture techniques for closing the sternum were compared with respect to postoperative sternal wound infections and cosmetic results. In this study, we included 100 patients who had undergone open-heart surgery. Skin wounds were closed with intracutaneous suture in 50 patients and with transcutaneous suture in the remaining 50. Superficial or deep sternal infections that developed within 6 postoperative weeks were evaluated. Cosmetic results were similar in the 2 groups. Deep wound infections were not observed in either group. Superficial infection of postoperative sternal wounds occurred at rates of 2% (n=1) and 16% (n=8) for transcutaneous and intracutaneous techniques, respectively (P = 0.016). One patient in the transcutaneous group and 6 patients in the intracutaneous group who developed superficial sternal infections were diabetic. Although the use of the transcutaneous suture technique in closing sternal incisions of cardiac surgery patients provided no cosmetic improvement, it decreased the risk of superficial sternal infection and reduced the length of postoperative hospital stay, particularly in diabetic patients.     

融合免疫学、生物化学和分子生物学综合性、设计性实验教学探讨

受河南大学实验课程的整合与创新研究项目的资助,针对临床医学专业的学生开设了"检测细胞凋亡"为主线,融合原来附属于生物化学、分子生物学和免疫学课程的实验课,收到了良好的实验教学效果。实践证明,学生对这种融合性、综合性系列实验特别感兴趣,这种实验教学模式,极大地激发了学生自主学习的积极性,在巩固和拓展了理论课学习内容的基拙上,培养了学生的科研素质、创新精神和动手能力。教学成果的取得,为医学基础实验课程的整合和教学方法的改革与创新提供了宝贵的经验。     

昆明某高校学生蠕形螨感染情况调查

目的　了解昆明医科大学在校学生蠕形螨感染情况及其对蠕形螨的认知情况,分析蠕形螨感染的相关影响因素,为大学生预防蠕形螨感染提供参考依据。方法　以昆明医科大学2014级必修《医学寄生虫学》课程的学生为调查对象。采用透明胶纸法对学生面部蠕形螨进行取样,显微镜检查并鉴定虫种,同时就性别、民族、生源地、皮肤类型等方面进行问卷调查。结果　共调查1 463人,蠕形螨阳性279名,总感染率为19.07%(279/1 463),男生和女生蠕形螨感染率分别为16.05%(96/598)和21.16%(183/865),差异有统计学意义([χ2] = 5.965,P < 0.05)。彝族、白族等少数民族学生蠕形螨感染率为18.33%（66/360）,不同民族蠕形螨感染率差异无统计学意义（P > 0.05）。感染类型以毛囊蠕形螨为主,感染率为50.54%(141/279);感染程度以轻度为主,占96.77%(270/279),无重度感染者。多因素非条件logistic回归分析显示,性别及舍友有蠕形螨感染是蠕形螨感染的危险因素,蠕形螨感染与民族、生源地、皮肤类型等无关。仅有2.53%(37/1 463)的学生了解蠕形螨相关知识。结论　昆明医科大学在校大学生面部蠕形螨感染率相对较低,感染与性别及舍友有蠕形螨感染密切相关。要加大在学生中开展卫生保健知识宣传的力度。     

A conservative procedure for the diagnosis of catheter-related infections

A prospective study was done in 139 intravascular catheters (IVCs) that had been removed for different reasons. The purpose of the study was to compare laboratory procedures for the diagnosis of catheter-related infections and also to attempt to clarify the present controversy regarding the portal of entry of such infections. The IVCs were removed by one of us and multiple samples were studied according to a standard procedure. Semi-quantitative cultures were performed of the tips, the interior of the hub, and the skin around the insertion point. Quantitative cultures were performed of the infusion fluid and of the IVC tips. Of the 139 IVCs studied, 53 (38.1%) were infected (greater than or equal to 15 colony-forming units per plate in the semiquantitative culture). Semi-quantitative and quantitative cultures gave comparable results, but the semiquantitative procedure proved to be easier and faster. All but three infected catheters had a positive (greater than or equal to 15 colony-forming units per plate) skin and/or hub culture (superficial cultures), with microorganisms identical to those isolated in the IVC tip. Our results showed two possible and differentiable portals of entry. Thirty (56.6%) had external origin (semiquantitative skin culture positive), 12 (22.6%) had an internal origin (semiquantitative hub culture positive), and 8 (15.1%) had both origins. All catheters with negative superficial cultures had a negative tip. The predictive value of positive superficial cultures in the diagnosis of catheter-related infection was 66.2% and that of negative cultures was 96.7%. In patients with suspected catheter-related infections but negative superficial cultures, the possibility of infection may reasonably be ruled out, thereby avoiding many unnecessary catheter withdrawals.     

翻转课堂结合TBL教学模式在生理学实验教学中的实践

目的 探讨翻转课堂教学方法结合以团队为基础的学习（TBL）在生理学实验教学中的效果。方法 研究对象选取72名临床医学本科学生。随机分为两组:实验组（36人）利用网络课程教学平台,在开课前以在线形式明确实验原理,整体技术路线并形成问题。对照组（36人）采用课题讲授和演示教学。通过成绩分析和问卷调查进行教学效果评价。学生对教学效果的评价以百分比表示,定量数据行t检验。结果 实验组综合测评平均成绩为（83.2±10.1）分;对照组综合测评平均成绩为（72.0±15.4）分,差异具有统计学意义（P<0.01）。调查显示,实验组85%以上学生认为,翻转课堂结合TBL教学模式有助于提升学习兴趣,有利于知识点的掌握及个人综合能力的提高。结论 翻转课堂与TBL教学相结合的新型教学模式可有效提高生理学实验教学效果,使学生的自主学习能力得以提高。     

Infection-related morbidity in systemic lupus erythematosus: A clinico-epidemiological study from Northern India

The present study was undertaken to retrospectively evaluate the frequency and pattern of infections in 309 patients with systemic lupus erythematosus (SLE) attending the Rheumatology Clinic of the All India Institute of Medical Sciences Hospital between January 1989 and May 1994. Eighty-two patients (26.5%) were found to be suffering from one or more infections during this period. Tuberculosis was the commonest infection observed. Seventy-four patient (23.9%) had a single infection, while 8 (2.6%) had multiple infections. The infection rate was found to be higher among patients with SLE and major organ involvement than among those with mild superficial SLE.     

邢台市某医学院校新生油性皮肤者面部蠕形螨感染调查

采用透明胶纸粘帖法对邢台医学高等专科学校308名油性皮肤新生面部蠕形螨感染情况进行调查,结果检出蠕虫螨感染者106人,总感染率34.4%,单纯毛囊蠕形螨感染占50.9%(54/106),单纯皮脂蠕形螨感染占20.8%(22/106),混合感染占28.3%(30/106);轻度感染占94.3%(100/106)。鼻侧感染率54.7%(58/106)较额部(47.1%)和鼻尖(35.8%)感染率高。该校新生油性皮肤者人体蠕形螨感染率较高,但以轻度感染为主。     

Superficial herpes simplex virus wound infection following lung transplantation

Surgical site infections (SSIs) are infections of tissues, organs, or spaces exposed by surgeons during performance of an invasive procedure. SSIs are classified into superficial, which are limited to skin and subcutaneous tissues, and deep. The incidence of deep SSIs in lung transplant (LTx) patients is estimated at 5%. No reports have been published as to the incidence of superficial SSIs specifically in LTx patients. Common sense would dictate that the majority of superficial SSIs would be bacterial. Uncommonly, fungal SSIs may occur, and we believe that no reports exist as to the incidence of viral wound infections in LTx patients, or in any solid organ transplant patients. We report a de novo superficial wound infection with herpes simplex virus following lung transplantation, its possible source, treatment, and resolution.     

心外科术后切口感染病原菌分布情况调查

目的调查心外科术后切口感染病原菌分布情况,指导临床抗感染防治。方法收集心外科术后患者临床资料。采集患者切口分泌物,经全自动微生物鉴定仪对病原菌类型进行鉴定;采用PCR法检测金黄色葡萄球菌毒力基因;对数据进行统计学分析。结果心外科手术患者496例,心外科术后切口感染患者35例,感染率7.06%;其中表浅切口感染患者22例,深部切口感染患者13例,分别占62.86%和37.14%,感染率分别为4.44%和2.62%;从心外科术后切口感染患者中共分离39株病原菌,其中革兰阳性菌21株、革兰阴性菌14株、真菌4株,构成比分别为53.85%、35.90%、10.26%;从表浅切口感染患者中分离革兰阳性菌13株,革兰阴性菌9株,真菌3株,构成比分别为52.00%、36.00%、12.00%;从深部切口感染患者中分离革兰阳性菌8株,革兰阴性菌5株,真菌1株,构成比分别为57.14%、35.71%、7.14%;分离自深部切口感染患者的金黄色葡萄球菌sasX、psm-mec、pvl毒力基因检出率分别为75.00%、25%、50%;分离自表浅切口感染患者的金黄色葡萄球菌sasX、psm-mec、pvl毒力基因检出率分别为62.50%、50.00%、37.50%。金黄色葡萄球菌毒力基因分布在表浅切口、深部切口感染中差异无统计学意义(P>0.05)。手术时间延长、术中失血、术中输血患者感染率分别为10.19%、11.17%和13.70%,感染率均高于其他患者,差异有统计学意义(P<0.05)。结论金黄色葡萄球菌是心外科术后切口感染的主要病原菌类型;金黄色葡萄球菌毒力基因与其临床致病性密切相关;手术时间延长、术中失血、术中输血是影响心外科患者术后切口感染发生的危险因素。